CPN(C) Perioperative key terms

The period during which a child refrains from eating or drinking before surgery, calculated by fasting intervals set for clear fluids, breast milk, formula, and solids to reduce aspiration risk during anesthesia induction.

The process of explaining a procedure's purpose, risks, benefits, and alternatives to a parent or guardian, confirming understanding, and documenting voluntary permission before surgery. Assent is sought from the child when developmentally able.

A child's own agreement to participate in care or a procedure, obtained in developmentally appropriate language alongside parental permission. It respects the child's growing autonomy without replacing legal guardian consent.

Measurements of temperature, heart rate, respiratory rate, blood pressure, oxygen saturation, and weight recorded before surgery. They provide the reference against which intraoperative and postoperative changes are compared.

The child's current level of cognitive, emotional, and social maturity, such as infancy, toddlerhood, school age, or adolescence. It guides how information is explained, how separation anxiety is managed, and how distraction is chosen.

Distress a young child experiences when parted from parents or caregivers, often peaking in toddler years. It can intensify during induction and recovery, so parental presence and comfort measures are planned in advance.

An approach that treats the child and family as partners in care, honoring preferences, sharing information openly, and involving caregivers in decisions, comfort, and daily routines throughout the perioperative experience.

Structural features unique to children: a proportionally larger head and tongue, a funnel-shaped larynx with a narrowest point at the cricoid, and a short trachea. These increase obstruction and intubation difficulty risk.

Immature ability of infants and young children to conserve heat because of greater body surface area relative to weight, limited subcutaneous fat, and immature shivering. They cool quickly in cool operating rooms.

The chance that stomach contents or secretions enter the airway during sedation or anesthesia, causing obstruction, pneumonia, or chemical injury. Fasting rules, suction readiness, and prompt airway positioning reduce it.

The transition from wakefulness to anesthesia, commonly by inhaled agent or intravenous medication in children. Nursing support includes positioning, distraction, monitoring, and readiness to assist with airway management.

A rare inherited reaction to certain anesthetic gases and muscle relaxants marked by rapidly rising temperature, rigid muscles, tachycardia, and acidosis. It requires immediate treatment with dantrolene and aggressive cooling.

A temporary state of confusion, agitation, and inconsolable distress some children show while waking from anesthesia. It usually resolves within minutes to an hour and is managed with safety measures and calm reassurance.

Practices that keep objects and areas free of all microorganisms, including sterile gowns, gloves, drapes, and instruments. Breaks in technique are corrected before the procedure continues to prevent surgical site infection.

The designated area of sterile drapes and equipment considered free of microorganisms. Only sterile items may touch it, and personnel must not reach over it or turn away from it while gowned.

Verification of sponges, needles, and instruments before, during, and at the close of a procedure, performed aloud by the circulating nurse and scrub person. Discrepancies are reported before the patient leaves the room.

A brief pause immediately before a procedure in which the team confirms patient identity, site, procedure, consent, allergies, and readiness. It prevents wrong-site surgery and other avoidable errors.

An infection developing at or near an incision within a defined period after surgery, ranging from superficial redness to deep organ involvement. Prevention includes asepsis, skin preparation, normothermia, and appropriate antibiotics.

An immune reaction to natural rubber latex proteins ranging from contact rash to anaphylaxis. Children with spina bifida or multiple surgeries are at higher risk, so latex-free supplies and screening are essential.

A severe, rapid allergic reaction with airway swelling, bronchospasm, low blood pressure, and rash. Immediate epinephrine, oxygen, fluids, and airway support are required, and the reaction must be documented for future care.

Scheduled observation of breathing, circulation, temperature, consciousness, pain, and surgical site after anesthesia. Frequent assessment in the recovery area detects complications such as airway obstruction, bleeding, or hypothermia early.

Age-specific normal ranges for heart rate, respiratory rate, blood pressure, and temperature in children. Knowing expected values helps nurses recognize deterioration, since infants normally breathe and beat faster than adults.

Systematic use of age-appropriate tools, such as behavioral scales for infants and self-report scales for older children, to measure pain intensity and response to treatment. Findings guide medication and comfort interventions.

Combining different pain-relief methods, such as scheduled acetaminophen, local nerve blocks, and opioids for breakthrough pain, so each works by a different mechanism. This improves comfort while reducing opioid side effects.

Practices that reduce harm from opioid medicines, including weight-based dosing, monitoring sedation and breathing, preventing duplication, and securing storage. Children are especially vulnerable to respiratory depression.

An option allowing a calm caregiver to stay with the child during the start of anesthesia. It can ease distress if the caregiver is prepared, willing, and able to follow staff direction.

Use of toys, medical props, and role play to help children understand and rehearse upcoming procedures. It reduces fear, supports coping, and allows expression of worries about surgery.

The legal documentation of assessments, medications, counts, positioning, specimens, and events across the surgical experience. Clear, timely entries support continuity, quality review, and defense of care delivered.

Acting to protect a child's rights, safety, and preferences when the patient cannot speak for themselves, including questioning unsafe orders, ensuring consent, and voicing comfort needs to the team.

The legally defined duties and limits of a nurse's role based on education, licensure, and facility policy. Nurses must recognize when a task requires delegation, supervision, or a different provider.

Structured, ongoing efforts to measure processes and outcomes, identify gaps, test changes, and sustain improvements in perioperative care, such as reducing surgical site infections or medication errors.

A structured transfer of patient information between care teams, often using a standardized format covering situation, background, assessment, and recommendations. It prevents omissions during transitions from operating room to recovery.

A guardian's or capable child's decision to decline a recommended intervention after receiving complete information about consequences. It is documented and respected, with concerns addressed and alternatives discussed.

Immediate, accurate identification of tissue or fluid removed during surgery with patient identifiers, site, and time, verified aloud by two staff. Errors can cause wrong diagnosis or treatment.

A core temperature below normal, common in pediatric surgery because of heat loss during exposure and cold fluids. It can impair clotting, slow drug clearance, and prolong recovery.